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OPERATORSTraining Date: Facility: /irL-Yl� J �(% Of S01lTNERM ULIfORNU APR-��-- 20 t�tS j IS(oo "Facility Employee" UST Compliance Training Sign -In Sheen 1 \-O ` � CA The people listed in the UST Compliance Training Sign -In Sheet below are employees at the indicated facility whose job responsibilities require them to respond to underground storage tank (UST) monitoring system alarms, spills or UST overfills. As such, they qualify as "facility employees" or FEs per CCR Title 23, Chapter 16, Section 2711. Some FEs are also facility owners / operators or facility managers reporting to the facility owner / operator. The column entitled O/O or Mgr Owner / Operator or Manager) indicates which listed FE is also an owner / operator or facility manager at the noted facility. Each identified FE must be annually trained in the environmental aspects of the proper operation and maintenance of the UST system at the facility. New hire FEs must be trained within 30 days of their hire date; otherwise they cannot be left in charge of facility UST operations until they have received their annual Please print legibly UST training. Training may be conducted in conjunction with monthly DO inspections, given advance notice. The UST Operators Designated Operator indicated at the bottom of this form has trained the listed FEs on the training date above in the following topics at a minimum: • Facility best management practices (use of system tests, documented responses, etc.) • The FE's role in monitoring system alarm responses as noted in the facility's Monitoring Plan. • The FE's role in spill and overfill responses as noted in the facility's Monitoring Plan. • Review of emergency contact procedures. 1/2 Employee Name Hire Date * Job Title Employee # Emrioyee Signature If known Lance York Facility DO Name 5296385 -UC / ust 12, 2016 confirmation of FE Training International Code Council (ICC) Certification # and Expiration Date